4G5-33778-99151
4 vaccinations
6 coded responses
27 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 631 / MO
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-03-24
Registered in v-safe
- 2021-03-24
- 2021-03-30
- 2021-04-06
-
2021-04-13
Dose 2 — Moderna
- 2021-04-13
-
2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Thirst — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Unusually thirstyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessFree text: Foggy brainMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2021-04-17
- 2021-04-19
- 2021-04-20
- 2021-04-27
-
2021-05-04
Survey response — day 21, dose 2MedDRA: Asthenia, Dizziness, Fatigue, Nausea, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: 17 days post second dose, I felt light headed, extremely fatigued, nauseous, mildly feverish, and weak. Symptoms began to lessen after 12 hours and fully resolved after 72 hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-07-13
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2021-10-12
Survey response — 6 months, dose 2MedDRA: Coronary artery disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Diagnosed with early coronary artery disease. Calcium CT scan score of 67.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-12
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-19
-
2021-10-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-08
Dose 3 — Moderna
- 2022-04-14
-
2022-04-18
Dose 4 — Moderna
- 2022-04-30
- 2022-05-03
- 2022-05-09
- 2022-05-16
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2022-05-23
Survey response — day 35, dose 4MedDRA: Brain fog, Discharge, Oropharyngeal pain — Feeling: FairFree text: Drainage and a bit of a sore throat yesterday and last night. Brain feels a little foggy.MedDRA releases: 2024-11 · check-in free text available
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2022-05-30
Survey response — day 42, dose 4MedDRA: Discharge, Fatigue, Oropharyngeal pain — Feeling: FairFree text: Drainage, sore throat, fatigue.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-20
- 2022-10-17
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-11-08 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Unusually thirsty
Systemic reaction (other): Foggy brain
Release 8 — day 21, dose 2
Symptoms: 17 days post second dose, I felt light headed, extremely fatigued, nauseous, mildly feverish, and weak. Symptoms began to lessen after 12 hours and fully resolved after 72 hours.
Release 10 — 6 months, dose 2
Symptoms: Diagnosed with early coronary artery disease. Calcium CT scan score of 67.
Release 11 — day 35, dose 4
Symptoms: Drainage and a bit of a sore throat yesterday and last night. Brain feels a little foggy.
Release 11 — day 42, dose 4
Symptoms: Drainage, sore throat, fatigue.
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Coronary artery disease | · | · | ✓ |
| SD | Discharge | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Thirst | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release